Mauritius has come a long way, from a growing economy to a rich and vibrant food culture that brings people together. But alongside this progress, our health landscape is quietly shifting, showing up in rising blood sugar levels, weight concerns, and more people living with chronic conditions at younger ages.
And yet, when it comes to obesity, the conversation often misses the mark. The conversation remains rooted in blame, stigma, and oversimplification. Obesity is not a failure of willpower; it is a complex, multifactorial condition shaped by biology, environment, culture, lifestyle, and access. And If we truly want to move forward, we need to shift the conversation, from judgment to understanding, and from quick fixes to sustainable, realistic strategies that support people in real life.
Let’s take a closer look at what truly drives obesity, and explore the latest treatment options, including emerging medications, with a balanced view of their benefits, limitations, and where they fit within a sustainable, long-term approach to health.
A Multifactorial Problem Across the Life Span
Obesity does not begin at adulthood. Its roots are planted early, sometimes before birth. In Mauritius, 17.1% of infants are born with a low birth weight (Global Nutrition Report), a condition strongly associated with compensatory fat accumulation in later childhood via the thrifty phenotype mechanism. These children are biologically primed for fat storage in an environment increasingly saturated with calorie-dense foods.
Among children aged 9–10, overweight prevalence reaches 15.8% in boys and 18.9% in girls, with obesity affecting ~5%. Urban children are nearly twice as likely to be obese as rural peers, reflecting environmental drivers such as food availability, reduced physical activity, and screen-based lifestyles. Academic pressures further reinforce sedentary habits from a young age.
Adolescence introduces additional risks: hormonal changes, emotional eating, and the normalization of processed, calorie-dense foods through social and digital culture.
In adulthood, weight gain is shaped by sedentary work, chronic stress, and the cultural centrality of food from fried snacks to rice-based meals. Data from the Mauritius Non-Communicable Disease Survey show obesity rising from 26.1% to 35.7% in men and 37.9% to 47.7% in women within five years despite national health initiatives, highlighting the limits of individual-focused interventions in an obesogenic environment.
Ethnic differences further complicate assessment. Mauritian Indians and Creoles exhibit higher body fat at equivalent BMI compared to Caucasians, meaning standard cut-offs may underestimate cardiometabolic risk locally.
Measuring Obesity: Beyond the Bathroom Scale
The Body Mass Index (BMI) remains the most widely used screening tool defined as weight in kilograms divided by height in metres squared, with obesity classified at ≥30 kg/m² but it is far from perfect, particularly in a multi-ethnic island context.
More nuanced indices now complement BMI in clinical practice:
- Waist Circumference (WC): A proxy for visceral (abdominal) fat, with action thresholds of >80 cm for women and >90 cm for Asian-origin men.
- Body Fat Percentage via Bioelectrical Impedance Analysis (BIA): Increasingly accessible in clinical settings and offers a more granular picture than weight alone.
Reframing Obesity: Beyond Blame
Classifying obesity solely as a chronic disease, while medically valid, carries an unintended consequence. It positions the person as a passive patient, stripped of agency. A lifestyle-centred framework, by contrast, acknowledges that obesity is primarily driven by a constellation of behaviours, environments, and socioeconomic conditions that are modifiable.
This distinction matters enormously in the Mauritian context. When a mother in Flacq feeds her child with roti because that is what is affordable and culturally familiar, she is not failing, she is navigating systemic barriers. When a young professional in Ebène gains weight eating at his desk during a 10-hour workday, the intervention is not simply ‘eat less, move more’, it is structural change in how we work, commute and rest.
Obesity Is Not a Taboo – It is a conversation we must have.
Stigmatising obesity causes real harm. It delays help-seeking, worsens mental health outcomes, and embeds the very behaviours it seeks to eliminate. The Mauritius Acceleration Plan to Stop Obesity 2024–2030, developed by the Ministry of Health and Wellness in collaboration with WHO, targets a 5% reduction in obesity prevalence across all age groups by 2030 and critically, it adopts a multi-sectoral, non-judgmental approach.
Every Mauritian deserves to discuss their weight with their healthcare provider without shame. Every child deserves a school environment that celebrates movement, not just academic performance. And every individual regardless of their size deserves dignity, access to care, and the full support of a society that understands that obesity is not a character flaw. It is a complex public health challenge requiring evidence, empathy, and systemic change.
This shift in understanding has also changed the way we approach treatment. Alongside lifestyle and behavioural strategies, science has introduced new medical tools that can support weight management in specific cases. Among the most discussed today are GLP-1 receptor agonists, a class of medications that is reshaping conversations around obesity care.
Before exploring how they work, it’s important to understand what they are, why they are being prescribed more frequently, and where they realistically fit within a long-term, sustainable approach to health.
GLP-1 Medications: A Tool, not a Magic Solution
GLP-1 medications represent an important development in obesity treatment and can be beneficial for some individuals when prescribed in specific medical cases and appropriately. However, they should always be viewed as one tool among many.
Long-term health outcomes depend on a comprehensive approach that includes medical care, nutrition support, physical activity, behavioural changes, and psychological wellbeing. The goal of obesity treatment should never be simply rapid weight loss. Instead, it should focus on improving overall health in a safe, sustainable, and balanced way.
How GLP-1 Medications Work
GLP-1 medications mimic a naturally occurring hormone in the body called glucagon-like peptide-1, which helps regulate blood sugar and appetite. These medications work through several mechanisms:
- They slow gastric emptying, meaning food stays longer in the stomach.
- They increase the feeling of fullness (satiety).
- They reduce appetite, which often leads people to eat less.
As a result, many individuals experience weight loss when using these medications. However, the same mechanism that reduces appetite can also create challenges. Many patients report significantly reduced hunger, sometimes to the point where eating becomes difficult. In some cases, individuals may experience side effects such as nausea, vomiting, or digestive discomfort. While this can contribute to weight loss, it may also lead to unintentionally inadequate food intake.
When used responsibly and within a multidisciplinary framework, new therapies such as GLP-1 medications can support individuals on their health journey while ensuring that nutrition and wellbeing remain at the centre of care.
When Weight Loss Comes with Nutritional Risks
When appetite drops dramatically, individuals may struggle to consume enough nutrients to meet their body’s needs. This can sometimes result in nutritional deficiencies, particularly if food intake becomes very limited over an extended period. We have observed cases where individuals lose weight but simultaneously develop issues such as:
- Iron deficiency and anemia
- Vitamin D deficiency
- Low protein intake
- Digestive discomfort or gastritis
From a health perspective, it raises an important point: weight loss should not come at the expense of overall nutritional health. Losing a few kilograms while developing significant nutrient deficiencies ultimately defeats the purpose of improving health.
The Importance of Medical Monitoring
For this reason, GLP-1 medications should always be used under medical supervision. Patients taking these medications benefit from:
- Regular medical consultations
- Periodic blood tests to monitor nutritional status
- Adjustments to the dosage when necessary
There should be no rush when it comes to weight management. A slower, well-monitored approach allows healthcare providers to ensure that weight loss occurs safely without compromising overall health.
The Critical Role of Nutrition and Dietitians
Dietitians help translate medication-induced changes in appetite and eating patterns into balanced, adequate, and sustainable nutrition habits. This includes ensuring sufficient nutrient intake, supporting muscle mass preservation, and preventing overly restrictive or disordered eating patterns that can sometimes emerge when appetite is significantly reduced.
Beyond the physiological aspects, dietitians also support the behavioural and emotional dimensions of eating. They help individuals rebuild trust with food, develop practical meal structures, and navigate social and cultural food environments without guilt or rigidity.
Dietitians can help patients:
- Prioritise nutrient-dense foods
- Maintain sufficient protein intake
- Manage side effects such as nausea
- Prevent potential nutrient deficiencies
- Develop sustainable eating habits that support long-term health
Without proper nutritional guidance, individuals may unintentionally compromise their health while attempting to lose weight.
Conclusion
Obesity is a complex condition that requires understanding, compassion, and evidence-based solutions. While modern medicine continues to develop new treatment tools, including GLP-1 medications, sustainable health outcomes rely on a holistic approach that considers the whole person.
Combining medical care, nutritional guidance, lifestyle support, and patient education remain essential for helping individuals manage their weight safely and effectively. Ultimately, the goal is not simply weight loss, but improving long-term health, wellbeing, and quality of life.
Eat Smart. Be Healthy.
With love & care,
Heinsha Halloowan Sookun, RD & Yovanee Veerapen, RD, MBA